Qualities of Effective Nutrition Education Interventions in Athletes: A Systematic Review and Meta-Analysis

Nutrition knowledge (NK) is consistently reported as low among athletes, potentially limiting optimal dietary intake, performance, recovery, and overall health outcomes. Sports dietitians have a responsibility to provide effective nutrition education and increase NK in athletes. Nutrition education interventions have been shown to improve NK, but practical application standards for designing and conducting nutrition interventions in athletes has yet to be established. The purpose of this meta-analysis is to measure the overall effect of nutrition education interventions on NK in athletes and identify characteristics of nutrition education interventions that effectively increase NK. Seven databases (Academic Search Premier, SPORTDiscus, MEDLINE, ERIC, Health Source: Nursing/Academic Edition, CINAHL Plus with Full Text, and Consumer Health Complete) were searched, yielding 125 studies. Fourteen studies met inclusion criteria and represented 755 athletes (ages 10-32) from various sports. SPSS was utilized to perform the meta-analysis with a random-effects model and DerSimonian-Laird procedure, and effect size (ES) estimates were expressed as Hedges' g. The overall ES of nutrition education intervention on NK was .949 (p < .001, 95% CI [.728, 1.171]), indicating a large statistically significant positive effect. Moderator analyses indicated that study design (Q = 12.577, p < .001), mode of intervention (Q = 17.479, p < .001), length (Q = 12.029, p = .002), and use of validated NK survey (Q = 19.430, p < .001) significantly influenced variation in ES. No significant differences were found for intervention type and participant age. Funnel plot asymmetry suggests potential publication bias, although Egger's test was nonsignificant (p = .897). Findings support the overall effectiveness of nutrition education interventions and provide practical insight into factors that may contribute to their success.